Friends of Help a Hedgehog Hospital … Membership form
Registered Charity Number 1156376
Thank you for becoming a Friend of Help a Hedgehog Hospital. We now offer our members the option to
become a regular monthly supporter and give a minimum of £3 per month by standing order. We hope those
who choose the annual membership option will also consider setting up a standing order as this is the simplest
and most cost effective method for us so that more of your money is spent on helping hedgehogs !
Part 1: Membership application... Return to Membership Secretary
Name:
Date:
Address:
May we send your newsletters by email? Email address:
Membership level:
Family/Couple £25/year ( ) O.A.P. £12.50/year ( ) Adult £15/year ( )
(Please tick box)
Junior (under 16) £7.50/year ( ) Please state date of birth
/
/
/
Supporter… £3/month by Standing Order ( ) Other amount/mth by Standing Order (
Payment method
Cheque enclosed ( )
We offer two methods
Standing order for annual membership fee ( )
of payment.
Monthly standing order for £3/month ( ) Other amount/month (please specify) £….…(
For cheque payments: Please return this form and your cheque to:
Friends of Help A Hedgehog Hospital, c/o Louise Little, Membership Secretary
57 The Bridle, Cashes Green, Stroud, GL5 4SQ
For Standing orders: Please return Part 1 of the membership form to the Membership Secretary, address as above.
Then, complete Part 2 of the form below and take to your bank or use on-line banking to set up your payment.
As soon as we receive notification of your standing order payment we will dispatch your membership pack.
………………………………………………. ……….Cut here…………………………………………………………
Part 2: Standing order form…Take to your bank or set up payment via Internet banking
I would like to set up a Standing order payable to the following, with immediate effect:
Account name: “ Help A Hedgehog Hospital”,
Bank name and branch: Lloyds TSB, 12 Rowcroft, Stroud, Gloucestershire, GL5 3BD
Sort code: 30 98 29
Account number: 01145001
Please pay the sum of (tick as appropriate) until cancelled by me in writing:
Annual fee:
 £15 per year (Adult) ( )
 £25 per year (Family/couple) ( )
 £12.50 per year (O.A.P.) ( )
 £7.50 per year (Junior/Under 16) ( )
Monthly donation:
 Supporter…£3 per month regular donation (
)
 Other monthly amount, please specify £……… (
)
Signed: ……………………………………………………………………………… Date: ………./………./……….
)
)